6119 COMMERCIAL AVE 2020-02-06 - Laserfiche WebLink

OLT ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT VVYI tY YMCA M SITEINFORMATION PROJECT ADDRESS: Q 1 AVQ �jU e , V\ 01`�], O' BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED Ed SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: _ 0 COMMERCIAL USE OF BUILDING: S f I`vi no) ()deo ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT#(if applicable)):: DESCRIPTION OF WORK: PGll'T 1/1,(1q01-e)6 CONTACT INFORMATION OWNER NAME: Yjil dmUAJ -€S\G VY lGx TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (0.II� O YY-1 r t I WC�C U pv-ej /� (�) ^/-, 7 CITY / 'Vn /I "r 1 1 STATE WA ZIP 0-V 2) 'l OWNER PHONE: (_2-Q 2/ ( �" l,QU914- OWNER EMAIL: N /A CONTRACTOR NAME: l In �VV`Se CONTRACTOR ADDRESS: STREET 017 \--7Q±�I D SE � SSTATE WA ZIP ' I�/�"CI1Z � CONTRACTOR PHONE:4Z 1 LOD '272_0) CONTRACTOR EMAIL: I vie Gym 01I I • uO yy) CONTRACTOR LIC.#(REQUIRED):(N Ong 01 2_-G Gi CITY OF EVERETT BUSINESS LIC.#(REQU,IED):0 Li-Lf\ (:6 PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:� CONTACT PHONE: /+ZJ 1 0 922_09) t�--ekSCA ) CONTACT EMAIL: IVCj ; G m I AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ord ances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisio,' of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# ��/�� E Mar. - Owner/Authorized Agent Signature f Date (Revised 9/23/2016)